- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $23.44 / $72.44
| Facility | | $4.07 | $23.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.14 / $4.57
| Professional | | $1.00 | $2.14 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $10.00
| Facility | | $2.34 | $2.34 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.41 / $1.82
| Professional | | $1.20 | $1.41 | $1.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.22 / $16.60
| Professional | | $7.08 | $11.22 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $6.31 / $10.47
| Facility | | $2.40 | $6.31 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.00 / $4.68
| Professional | | $1.41 | $2.00 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.82 / $3.55
| Professional | | $2.34 | $2.82 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.98 / $4.68
| Professional | | $1.95 | $3.98 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.14 / $2.34
| Facility | | $2.09 | $2.14 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.88 / $5.01
| Professional | | $2.09 | $2.88 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.72 / $10,000.00
| Facility | | $2.14 | $3.72 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.72 / $10,000.00
| Professional | | $2.14 | $3.72 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.34 / $4.07
| Facility | | $1.00 | $2.34 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.04 / $3.31
| Professional | | $1.41 | $2.04 | $3.31 |